A regenerative approach to the pharmacological management of hard-to-heal wounds.

Autor: van de Vyver M; Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa. Electronic address: vandevyverm@sun.ac.za., Idensohn PJ; Clinicare Medical Centre, Ballito, KwaZulu-Natal, South Africa. School of Nursing, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa., Niesler CU; Discipline of Biochemistry, School of Life Sciences, University of KwaZulu Natal, Scottsville, South Africa.
Jazyk: angličtina
Zdroj: Biochimie [Biochimie] 2022 May; Vol. 196, pp. 131-142. Date of Electronic Publication: 2022 Jan 19.
DOI: 10.1016/j.biochi.2022.01.006
Abstrakt: A wound is considered hard-to-heal when, despite the appropriate clinical analysis and intervention, the wound area reduces by less than a third at four weeks and complete healing fails to occur within 12 weeks. The most prevalent hard-to-heal wounds are associated with underlying metabolic diseases or vascular insufficiency and include arterial, venous, pressure and diabetic foot ulcers. Their common features include an abnormal immune response and extended inflammatory phase, a subdued proliferation phase due to cellular insufficiencies and finally an almost non-existent remodeling phase. Advances in wound care technology, tested in both pre-clinical models and clinical trials, have paved the way for improved treatment options, focused on regeneration. These interventions have been shown to limit the extent of ongoing inflammatory damage, decrease bacterial load, promote angiogenesis and deposition of granulation tissue, and stimulate keratinocyte migration thereby promoting re-epithelialization in these wounds. The current review discusses these hard-to-heal wounds in the context of their underlying pathology and potential of advanced treatment options, which if applied promptly as a standard of care, could reduce morbidity, promote quality of life, and alleviate the burden on a strained health system.
(Copyright © 2022 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.)
Databáze: MEDLINE
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